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Background: COVID-19 has further burdened the Brazilian healthcare system, especially emergencies. Patients may have delayed seeking care for surgical abdominal pain. Delays in the approach may have impacted clinical evolution and outcomes. This study evaluated appendectomies and their complications performed by the public system during one-year follow-up of COVID-19 in a hospital in southern Brazil. Materials and methods: In this hospital-based cross-sectional study, we included adult patients who underwent appendectomy from March 2019 to April 2021 (n = 162). Patients were divided into pre-pandemic (n = 78) and pandemic (n = 84) groups based on the surgery date. The analyzed variables included hospitalization duration, intensive care unit (ICU) admission, surgical approach, histopathological findings, COVID-19 testing, patient outcomes, and 30-day survival rate. Results: The cohorts exhibited similar epidemiology, with the sex ratio and average age being maintained. No statistical difference was found in the 30-day survival rate and clinical outcomes. Of the four patients admitted to the ICU, three belonged to the pandemic cohort and tested negative for COVID-19. Only 47.6 % of the patients in the pandemic cohort underwent COVID-19 polymerase chain reaction examination; one tested positive (2.5 %). Conclusion: This study demonstrated that there was no increased risk for appendectomies during the first wave of the pandemic. Surgeries were safe during this period. Patients continued to access the emergency service despite surgical abdominal pain and restrictive measures imposed by health authorities. The similar results observed across cohorts are attributed to the readiness of the teams and the availability of medical surgical equipment in safe quantities.

Abstract Helicobacter pylori infection is involved in gastric diseases such as peptic ulcer and adenocarcinoma. Approved antibiotherapies still fail in 10 to 40% of the infected patients and, in this scenario, targeted nanotherapeutics emerged as powerful allies for H. pylori eradication. Nano/microparticles conjugated with H. pylori binding molecules were developed to eliminate H. pylori by either (i) blocking essential mechanisms of infection, such as adhesion to gastric mucosa or (ii) binding and killing H. pylori through the release of drugs within the bacteria or at the site of infection. Glycan antigens (as Lewis B and sialyl-Lewis X), pectins, lectins, phosphatidylethanolamine and epithelial cell membranes were conjugated with nano/microparticles to successfully block H. pylori adhesion. Urea-coated nanoparticles were used to improve drug delivery inside bacteria through H. pylori UreI channel. Moreover, nanoparticles coated with antibodies against H. pylori and loaded with sono/photosensitizers, were promising for their application as targeted sono/photodynamic therapies. Further, non-specific H. pylori nano/microparticles, but only active in the acidic gastric environment, coated with binders to bacterial membrane, extracellular polymeric substances or to high temperature requirement A protease, were evaluated. In this review, an overview of the existing nanotherapeutics targeting H. pylori will be given and their rational, potential to counteract infection, as well as level of development will be presented and discussed.

Isotretinoin is an oral medication commonly utilized to treat severe acne. It belongs to the class of retinoids and is a synthetic form of vitamin A. Possible changes in bone tissue associated with the systemic administration of Isotretinoin for long periods and in high doses, such as hypercalcemia, osteopenia, diffuse hyperostosis, or even skeletal deformities, are reported in scientific studies. The objective of this literature review was to analyze the available scientific literature on the systemic administration of Isotretinoin and its effects on bone tissue. To this end, articles that demonstrate effects of Isotretinoin on bone metabolism, bone mineral density, bone formation, and resorption, in addition to possible changes generated in this tissue were considered valid for inclusion in this literature review. The search for articles that fit the premise of this work was carried out in the PubMed/MEDLINE database. In a preliminary search, 85 articles were obtained; after in-depth investigation and checking of the inclusion and exclusion criteria, 21 articles were selected, with 17 articles reporting the effect of systemic administration of Isotretinoin in humans and four articles analyzing the effect generated by this substance systemically administrated in animals, more specifically in rats. After analyzing the selected articles, it was possible to observe several reports on hyperostosis or even changes in the formation of bone structures in human patients. Concerning animals, the largest number of studies addressed the changes caused in the formation or development of bone structures by the systemic administration of Isotretinoin. From the current analyses, and given the wide use of Isotretinoin, it is necessary to know its viability and influence on tissues. Its clinical efficacy seems to overcome any of the skeletal side effects observed; however, more studies are necessary to properly evaluate and prove the effects generated on bone tissues as well as other structures.

Abstract Background Despite 18 years since health surveillance regulations were promulgated in Brazil to govern Long-Term Care Institutions for Older Adults (LTCIs), many institutions fail to comply with the Differentiated Regime for Public Procurement (Resolution No. 502/2021) due to structural and operational conditions. This study aimed to investigate Brazilian LTCI managers’ understanding of challenges that significantly impact institutional operation and gather suggestions for enhancing RDC No. 502/21. Methods A cross-sectional, exploratory, and qualitative study was conducted, involving 90 managers or technical supervisors from Brazilian LTCIs. Data were collected using a self-administered Google Forms instrument and analyzed through Thematic Analysis based on the Organizing for Quality (OQ) framework. Results The most impactful challenges for LTCIs were healthcare, financing, human resources, relationship with oversight bodies, and family members. Discussion Proposed improvements for RDC No. 502/21 included enhanced professional training, infrastructure revision, increased financial support from the state, realistic oversight/regulations, and tailored monitoring approaches. Conclusion LTCIs in Brazil face numerous challenges, and the suggested improvements aim to adapt regulations to institutional realities. However, considering the regulations’ variability and purposes, further investigation is warranted.

BACKGROUND AND OBJECTIVES: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect reported by patients receiving cancer treatment, and it can affect treatment success, patient outcomes, and quality of life. CIPN typically begins with symmetrical progressive sensory alterations of the hands and feet in a stocking-gloving distribution. Currently, there is no standard treatment or intervention for the prevention, mitigation, or management of CIPN. CASES REPORT: This study represents the activity of the Pain Multidisciplinary Unit of Hospital Santa Maria in Lisbon from 2018 to 2023, specifically on oncologic patients with chemotherapy-induced peripheral neuropathy. In total, this unit observed 57 patients, 43.9% had colon/rectum cancer, 28.1% hematological, 21.1% breast, 3.5% gastric, 1.8% ovarian and 1.8% lung. The most frequent chemotherapeutic agent used was oxaliplatin (40.4%), followed by capecitabine (24.6%) and paclitaxel (22.8%). The most prescribed combination of chemotherapy agents was capecitabine with oxaliplatin, according to the CAPOX protocol. The multidisciplinary unit, in conjunction with the oncology department, has set a new procedure in which patients receiving chemotherapy with one of the known agents linked with CIPN wear a pair of frozen gloves and socks. Three patients have undergone this prevention method, none of the patients has reported symptoms of CIPN. CONCLUSION: This study contributes to draw attention to this important and limiting condition, and it also contributes to gather evidence on preventive measures that reduce the incidence of CIPN.

This research aims to conduct a systematic literature review (SLR) on intelligent sensors and the Internet of Things (IoT) in assistive devices for the deaf and hard of hearing. This study analyzes the current state and promise of intelligent sensors in improving the daily lives of those with hearing impairments, addressing the critical need for improved communication and environmental interaction. We investigate the functionality, integration, and use of sensor technologies in assistive devices, assessing their impact on autonomy and quality of life. The key findings show that many sensor-based applications, including vibration detection, ambient sound recognition, and signal processing, lead to more effective and intuitive user experiences. The study emphasizes the importance of energy efficiency, cost-effectiveness, and user-centric design in developing accessible and sustainable assistive solutions. Moreover, it discusses the challenges and future directions in scaling these technologies for widespread adoption, considering the varying needs and preferences of the end-users. Finally, the study advocates for continual innovation and interdisciplinary collaboration in advancing assistive technologies. It highlights the importance of IoT and intelligent sensors in fostering a more inclusive and empowered environment for the deaf and hard-of-hearing people. This review covers studies published between 2011 and 2024, highlighting advances in sensor technologies for assistive systems in this timeframe.

Introdução: A legislação vigente para bancos de sangue determina que os serviços de hemoterapia devem realizar, em todas as doações, testes para as doenças transmitidas pelo sangue (HIV, HTLV, Hepatite C (HCV), Hepatite B (Anti-HBc e HBsAg), Sífilis e doença de Chagas). O kit utilizado nesses testes deve possuir alta sensibilidade e especificidade para aumentar a segurança transfusional e diminuir os riscos de contaminação.Objetivo: Avaliar o descarte sorológico de doadores de sangue da COLSAN no ano de 2023. Material e métodos: Foi realizado levantamento das informações da coleta e do descarte sorológico de 166.629 doadores triados em 2023 pelo laboratório de sorologia da COLSAN. A metodologia utilizada foi eletroquimioluminescência. Os dados foram coletados de relatórios emitidos pelo sistema informatizado utilizado na Instituição (Eblood) e analisados em indicadores mensais da Instituição.Resultados: Em 2023 foram triadas amostras de 166.629 doadores de sangue e o descarte sorológico foi de 1,78%. Os parâmetros com os maiores descartes foram Sífilis (0,94%) e Anti-HBc (0,48%), já os parâmetros com os menores descartes foram HBsAg (0,03%) e doença de Chagas (0,04%). Os demais parâmetros apresentaram valores medianos comparados com os demais, HCV (0,13%), HIV (0,12%) e HTLV (0,11%). Discussão e conclusão: De acordo com o relatório de Produção Hemoterápica Brasileira de 2023, disponibilizado pela Anvisa, os descartes sorológicos encontrados nesse trabalho estão todos abaixo dos valores encontrados no Brasil, possivelmente pela sensibilidade e especificidade do teste utilizado e pela regionalização dos postos de coleta. Apesar de observarmos na população um aumento da contaminação por Sífilis, a alta positividade encontrada no banco de sangue também pode estar relacionada com a cicatriz sorológica, assim como a positividade para Anti-HBc. Conhecer a positividade dos doadores é de extrema importância para o direcionamento das possíveis ações de saúde para a população, pensando na prevenção, orientação e tratamento das doenças existentes.

O objetivo deste trabalho foi analisar artigos, publicações e estudos relacionados sobre o diagnóstico laboratorial etratamento dos portadores de talassemia, bem como aconselhar, do ponto vista genético, quando o portador da doençadecide ter descendentes (filhos biológicos). Foi realizado uma revisão bibliográfica com buscas em livros e artigos disponíveis nas bases de dados MEDLINE,LILACS e SCIELO e em artigos disponibilizados on line, por meio de revistas eletrônicas.Para as buscas foram utilizadas as seguintes combinações de palavras-chave em português e inglês: Talassemia; Hemoglobinopatia; Diagnóstico laboratorial; Tratamento (Thalassemia; Hemoglobinopathy; Laboratoy diagnostis; Treatment). Foram incluídos artigos publicados em periódicos nacionais e internacionais, no período de 2000 a 2023, que abordamtemas relacionados a diagnóstico laboratorial na identificação da talassemia e excluídas publicações que não forampertinentes ao estudo. Os critérios de exclusão foram: artigos e periódicos que abordassem sobre outrashemoglobinopatias, publicados antes do ano de 2000, os artigos, livros e periódicos publicados em língua diferente aoportuguês ou inglês. O diagnóstico da doença começa com hemograma que levanta suspeita da doença, tanto pelo baixo nível dehemoglobina quanto pelo tamanho das células vermelhas do sangue, menores que o normal. No entanto, a comprovaçãoexige o estudo da hemoglobina, através da eletroforese/HPLC (Cromatografia Líquida de Alta Performance), onde éusado corrente elétrica para separar as diferentes formas de hemoglobinas e detectar assim, hemoglobina anormal, etambém, por análise molecular onde se investiga mutações nos genes HBA1 e HBA2, caracterizado por síntesediminuída das cadeias globínicas, este exame é capaz de identificar deleções/duplicações nos genes da hemoglobinapela técnica de PCR (Reação em Cadeia da Polimerase), fechando assim o diagnóstico da talassemia.Até os anos de 1990, muitas pessoas vinham a óbito durante a infância ou na adolescência devido as complicações dastalassemias mais graves como infecções ou insuficiências cardíacas devido o depósito de ferro no miocárdio. Com oadvento da introdução ao teste do pezinho exames relacionados as hemoglobinopatias facilitou o manejo da doença emrecém-nascidos, com o diagnóstico precoce um melhor acompanhamento da evolução da doença e seu tratamento.As principais complicações da falta de diagnóstico precoce e adequado, principalmente nas variantes mais graves dadoença como a b-talassemia maior, são anemias graves, eritropoiese ineficaz, deformações ósseas devido a hiperplasiamedular, hepatoesplenomegalia, infecções e outros. O diagnóstico precoce e um tratamento mais específico, proporcionará melhores expectativas e qualidade de vida aopaciente portador de talassemia se tornando fator imprescindível. O diagnóstico das talassemias é realizado através dehemogramas, eletroforese, cromatografia líquida de alta performance e através de diagnóstico por biologia molecular. Tais metodologias diagnósticas têm direcionado o tratamento, e de acordo com a gravidade da talassemia instalada, pode levar ao uso contínuo da terapia transfusional e uso de quelantes de ferro para proteger os órgãos da sobrecarga doíon ferro, que é nocivo a vários órgãos principalmente o coração.

Resumo Neste dossiê, congregamos pesquisas que descrevem e analisam relações constituídas sob o efeito dos big data. A partir de espaços bastante distintos entre si - o jurídico, o burocrático, o agrícola, o biotecnológico, o econômico, o pornográfico -, voltamo-nos às agências conflitivas e criativas implicadas no que os dados fazem ver e no que são capazes de criar por meio de seu potencial de hiper-relacionalidade. Discutimos, então, a relação dos volumosos bancos de dados com aparatos diversos, como aplicativos, satélites, microscópios, documentos e algoritmos, capazes de arranjar e distribuir elementos informacionais por meio de práticas comparativas. Examinamos procedimentos de coleta e processamento de big data em diferentes setores e instituições; a pulverização das linguagens algorítmicas e estatísticas; as exigências crescentes por transparência, precisão e celeridade; a vinculação entre o tratamento de dados e as possibilidades de desenvolvimento democrático e sustentável. É dada especial atenção às transformações éticas e epistemológicas que envolvem os big data, bem como os efeitos da mobilização de conhecimentos computacionais por especialistas, incluídos aí os/as próprios/as antropólogos/as, em diferentes ambientes de produção de conhecimento.

ABSTRACT Objectives: to construct a Subcutaneous Hydration Device semi-functional prototype and gather initial information to improve this prototype design and realize its acceptance potential. Methods: a qualitative, descriptive and exploratory study, which used focus group, following the Technology Acceptance Model. The group was held at the Escola Superior de Enfermagem de Coimbra, Portugal, in December 2022, composed of nine participants from six different disciplinary areas, and followed thematic analysis. Results: four topics emerged associated with the device components: elastomeric infusion pump; needle/access device; clamp; administration set. From these topics, topics were triggered that highlighted: characteristics about the target population; ease of use and accessories; patient comfort and safety; and device application context. Final Considerations: the Subcutaneous Hydration Device semi-functional prototype is viable and interesting for the clinic. The results support its improvement and direct future investments for experimental studies.

Listeria monocytogenes and Cronobacter sakazakii are two important foodborne bacterial pathogens. Bacterial endophytes, which reside in plant cells, can produce antimicrobial compounds to protect the host organism or inhibit pathogens. This study investigated the bacterial community of tropical fruits for their potential to inactivate L. monocytogenes or C. sakazakii in cantaloupe and liquid infant formula, respectively. Tropical fruits including papayas, dragon fruits, and sugar apples, were sourced from several countries. Candidate bacterial endophytes were recovered from these tropical fruits using blood agar and Reasoner’s 2A (R2A) agar and tested for potential inhibition against L. monocytogenes and C. sakazakii. A total of 196 bacterial endophytes were recovered from papayas, dragon fruits, and sugar apples. Among these bacterial endophytes, 33 (16.8%) and 13 (6.6%) of them demonstrated an inhibition zone against L. monocytogenes and C. sakazakii, respectively. The inhibitory strains were identified using 16S rRNA sequencing as Bacillus spp., Enterobacter spp., Klebsiella spp., Microbacterium spp., Pantoea spp., and Pseudomonas spp. A cocktail of Pantoea spp. and Enterobacter spp. was used in challenge studies with cantaloupe and significantly reduced the number of L. monocytogenes by approximately 2.5 log10 CFU/g. In addition, P. stewartii demonstrated antagonistic activity against C. sakazakii in liquid infant formula, i.e., it significantly decreased the number of C. sakazakii by at least 1 log10 CFU/mL. Thus, the use of bacterial endophytes recovered from fruits and vegetables could be a promising area of research. Their use as potential biocontrol agents to control bacterial pathogens in ready-to-eat foods warrants further investigation.

Abstract Background Inherited retinal diseases (IRDs) are a group of rare degenerative disorders of the retina that can lead to blindness from birth to late middle age. Knowing the target population and its resources is essential to better plan support measures. The aim of this study was to evaluate the socioeconomic characteristics of regions in Portugal where IRD patients reside to inform the planning of vision aid and rehabilitation intervention measures. Results This study included 1082 patients from 973 families, aged 3 to 92 years, with a mean age of 44.8 ± 18.1 years. Patients living with an IRD were identified in 190 of the 308 municipalities. According to this study, the estimated IRD prevalence in Portugal was 10.4 per 100,000 inhabitants, and by municipalities, it ranged from 0 to 131.2 per 100,000 inhabitants. Overall, regions with a higher prevalence of IRD have a lower population density (r=-0.371, p

ABSTRACTRhinovirus causes respiratory tract infections in children and is found in co-infections. The objective of this research was to study the clinical profile of rhinovirus infection and co-infection in children with severe acute respiratory infection (SARI) during the COVID-19 pandemic period. We included 606 children ranging in age from 0.1 to 144 months of age from March 2020 to December 2021, hospitalized in the Pediatric Intensive Care Unit (PICU). The samples were collected by secretion from the nasopharynx region. A total of 259 children were tested positive for viral infection, 153 (59.07%) of them had a single rhinovirus infection and, 56 (36.6%) were aged between 60.1 and 144 months. Nine types of co-infections were identified and were found coinfection with three or more viruses (22/104, 21.15%). Observing the seasonality, the number of cases was similar between 2020 (49.53%) and 2021 (51.47%). Patients with a single infection (86.88%) and coinfection (67.30%) were more likely to have coughed. Patients with co-infection required the use of O2 for longer than those with a single rhinovirus infection. Hemogram results obtained from individuals with a single infection had higher levels of urea when compared to patients with co-infection with and other respiratory viruses. Multiple correspondence analyses indicated different clinical symptoms and comorbidities in patients with co-infection compared to those with single infection. The results found that the rhinovirus was much prevalent virus during the pandemic period and was found in co-infection with other virus types, what is important to diagnostic for the correct treatment of patients.

The wild boar, an impactful invasive species in Brazil, is subject to population control activities, which often include the use of hunting dogs. Hunters commonly consume wild boar meat, which is also used to feed their dogs, posing a risk of Toxoplasma gondii infection for humans and both T. gondii and Neospora caninum for dogs. The study aimed to investigate the prevalence of infection in wild boars (n = 127) and hunting dogs (n = 73) from São Paulo, Rio Grande do Sul, and Paraná states. We employed histopathological, serological (indirect fluorescent antibody test), and molecular techniques (endpoint polymerase chain reaction). Histopathology slides of wild boar tissue (central nervous system, heart, skeletal muscle, liver, spleen, kidney, gastrointestinal tract, pancreas, lymph nodes, and thyroid) sections revealed no T. gondii or N. caninum cysts (0/47). Antibodies anti-T. gondii were detected in 35/108 (32.4%) and anti-N. caninum in 45/108 (41.7%) wild boars. Only 2/18 (11.1%) wild boar tissue homogenate samples tested positive for T. gondii on endpoint PCR. Hunting dogs showed antibodies against T. gondii in 62/73 (85%) and against N. caninum in 31/73 (42%). The presence of antibodies against T. gondii and N. caninum in wild boars and hunting dogs, along with T. gondii DNA detection in wild boars, indicates the circulation of these parasites. Educating hunters on preventing these foodborne diseases, including zoonotic risks, is crucial.

Abstract At high temperatures, concrete may exhibit adverse mechanical behavior that compromises the safety of structures. Thus, it is necessary to study and develop concrete that can obtain greater performance in situations of exposure to high temperatures. In this regard, the present study investigates the replacement of 25% of sand by expanded vermiculite in different types of concrete and its performance when subjected to room temperature and punctual temperatures, of little content in literature, such as 200°C, 400°C and 800°C. This study also innovates by proposing the evaluation of prototypes exposed to high temperatures exclusively according to the perspectives of Brazilian technical standards, without resorting to international guidelines. Thus, the consistencies of the mixtures were determined and analyzed, as well as physical and mechanical tests that were carried out with the produced concrete. Among the results found are: vermiculite reduces the workability of the concrete mixture; vermiculite is not recommended for high-performance concrete, as it can significantly reduce its mechanical properties; in general terms, concrete that has a design strength of 50 MPa benefits from replacing the fines aggregate with vermiculite. From 400°C of exposure, all of the concrete samples showed cracks. The spalling phenomenon was also noticed in some specimens. The developed concrete samples cannot be characterized as lightweight concrete according to Brazilian standards, but o can be recommended as structural concrete given that their apparent specific mass is greater than 2000 kg/m3.

Objetivo: Analisar, a partir da perspectiva crítica e interseccional, a organização, composição e atuação legislativa de comissão voltada aos direitos sexuais e reprodutivos de mulheres, denominada Frente Parlamentar de Combate ao Aborto – Pró-Vida. Metodologia: Foi realizada leitura interseccional acerca da constituição de Frente Parlamentar de Combate ao Aborto - "Pró-Vida", da Assembleia Legislativa do Estado de Goiás (ALEGO), e o perfil sociodemográfico de seus integrantes foi traçado, discutido a luz dos marcadores sociais gênero, raça/etnia, classe social e religião, e problematizado acerca de um tema que implica diretamente na saúde e na vida das mulheres, o aborto. Resultados e Discussão: a análise dos resultados aponta a sub-representividade feminina, a prevalência de pessoas brancas e o predomínio de ideologia conservadora nos costumes e religião no perfil sociodemográfico dos membros integrantes da frente parlamentar estudada. Em contraponto, a literatura, ao discutir os marcadores sociais em investigação, traz o retrato daquelas que optam por realizar o aborto como sendo o de mulheres negras, de baixa renda e escolaridade, e que procuram em partidos de viés progressista advocacia para suas causas. Conclusão: A estrutura tradicional, presente na frente parlamentar investigada, enfrenta desafios na construção de um debate representativo e capaz de reproduzir nas políticas públicas as complexas identidades, necessidades e experiências das mulheres em risco de abortamento. Nessa argumentação, a construção de práticas políticas e tratos legislativos devem, prioritariamente, considerar as complexidades identitárias e as intersecções e opressões que levam as mulheres ao aborto para, enfim, construir-se uma democracia inclusiva, equitativa e representativa. Submissão: 22/02/24| Revisão: 12/03/24| Aprovação: 24/04/24

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Justificativa e Objetivos: A leptospirose, doença infecciosa causada pela bactéria Leptospira spp., tem a epidemiologia pouco conhecida em Minas Gerais, o que dificulta sua prevenção e controle. O objetivo deste estudo é traçar o perfil epidemiológico da leptospirose no estado de Minas Gerais no período de 2012 a 2022. Métodos: Estudo epidemiológico ecológico, realizado pela coleta de dados no Sistema de Informações de Agravos de Notificações, disponibilizado pelo banco de dados secundários do Departamento de Informática do Sistema Único de Saúde. Foram coletados dados referentes aos casos da doença notificados no local e período selecionados e realizadas análises estatísticas descritivas a partir das variáveis sociodemográficas e clínico-epidemiológicas. Resultados: Foram notificados 1.728 casos de leptospirose. O maior número de notificações foi em 2020 e menor em 2015. Há maior ocorrência da doença na população branca (46,30%), no sexo masculino (81,66%) e na faixa etária de 40 a 59 anos (38,77%). Observando a evolução da doença, nota-se que, de 2012 a 2022, foram registrados óbitos pelo agravo da leptospirose em 9,29% dos casos. A cura se manteve com maior ocorrência: 1,415 altas nessa década (81,89%). Conclusão: Com base nos resultados obtidos conclui-se que há predomínio de pacientes do sexo masculino, raça branca, faixa etária entre 40 e 59 anos e mais de 80% dos casos notificados resultaram na recuperação do quadro de saúde do paciente.